Healthcare Provider Details

I. General information

NPI: 1134743818
Provider Name (Legal Business Name): TAYLOR LEHAROLD ALSPAUGH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2020
Last Update Date: 08/04/2024
Certification Date: 08/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W GREENLAWN AVE
LANSING MI
48910-2819
US

IV. Provider business mailing address

1990 UNION LAKE RD STE 350
COMMERCE TOWNSHIP MI
48382-2288
US

V. Phone/Fax

Practice location:
  • Phone: 517-975-6000
  • Fax:
Mailing address:
  • Phone: 248-301-5898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number5151014342
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number5101027930
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: